The United Health Foundation has released its state health rankings for 2011, and if you think your state made the list, you might just have a surprise coming.

Before I hit you with the top ten list, a few overall trends:

Overall, America’s health didn’t change much this year.

Smoking is down 41% since 1990 — but cancer deaths have only slightly decreased.

Heart attack deaths, however, are decreasing.

Air pollution is improving steadily.

More children now live in poverty than in 2002, and the United States is 43rd in the world for infant mortality.

Fewer people have health insurance than they did in 2002.

2011 is the first year where every single state has an obesity rate of at least 20%.

But enough of the doom and gloom! Let’s find out where all the healthy hotties live.

Top Ten Healthiest States in America

Vermont

New Hampshire

Connecticut

Hawaii

Massachusetts

Minnesota

Utah

Maine

Colorado

Rhode Island

Now, I can practically hear the entire West Coast gasping in collective shock. No, not one Pacific state made the list. Oregon and Washington came in at respectable #14 and #15, but California is a totally mediocre #24.

Meanwhile, Vermont and New Hampshire shine, as they’ve done for the past three years running. Why? Infectious disease and violent crime are low. People tend to have health insurance and get early prenatal care. Obesity is lower than in other parts of the country. People eat well, are physically active and almost always finish high school before starting a family. And both unemployment and income disparity are relatively low.

Why did health-conscious Cali score so low? Well, despite the fact that nobody smokes, California has the worst air quality in the nation, and a high percentage of people without health insurance. Plus, poverty, diabetes and obesity are all on the rise. Worse, California has one of the highest rates of unemployment in the nation, coupled with high income disparity and a low high school graduation rate. That indicates that things will get worse over time.

Which state scored dead last? Mississippi, with the nation’s worst scores on poverty, obesity, diabetes, smoking, death rates and overall health status. Sadly, this is Mississippi’s tenth consecutive year in 50th place.